Perception and management of fever in infants up to six months of age A survey of US pediatricians 英文参考文献.docVIP

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Perception and management of fever in infants up to six months of age A survey of US pediatricians 英文参考文献.doc

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Perception and management of fever in infants up to six months of age A survey of US pediatricians 英文参考文献

ElKhouryetal.BMCPediatrics2010,10:95 /1471-2431/10/95 RESEARCH ARTICLE OpenAccess Perceptionandmanagementoffeverininfants uptosixmonthsofage:AsurveyofUS pediatricians AntoineCElKhoury1*,EmilyDurden2,LarryMa1,LeonaEMarkson1,AndrewWLee1,YinghuiDuan4, KathleenFoley3 Abstract Background:Afeverisanincreaseinthebody’stemperatureabovenormal.ThisstudyexaminedhowUS pediatriciansperceiveandmanagefevergenerallyversusfeveroccurringaftervaccinationininfantsuptosix monthsofage. Methods:Aweb-basedsurveyof400USpediatricianssubscribingtothePhysicianDeskReferencewasconducted inDecember2008.Datawerecollectedontherespondents’socio-demographics,numberofyearsinpractice,type ofpractice,theirdefinitionoffeverseverityininfants,andtheirrecommendationsformanagingfever.Generalized EstimatingEquationswereusedtoestimatetheoddsofapediatricianrecommendinganemergencyroomvisit (ER)orahospitaladmission,officevisits,orothertreatmentoption,asafunctionofinfant’sage,temperature, whethertheinfanthasrecentlyreceivedavaccine,andwhetherthefeverwasreportedduringorafteroffice hours,adjustingforpracticetypeandsocio-demographicvariables. Results:On average, the 400 responding pediatricians’ (64% were female, average age of 49 years, years in practice =20 years) threshold for extremely serious fever was ≥39.5°C and ≥ 40.0°C for infants 0-2 month and 2-6 month of age respectively. Infants were more likely to be referred to an ER or hospital admission if they were ≤ 2 months of age (Odds Ratio [OR], 29.13; 95% Confidence interval [95% CI], 23.69-35.82) or 2-4 months old (OR 3.37; 95% CI 2.99-3.81) versus 4to6months old or ifthey had atemperature ≥40.0°C (OR 21.06; 95% CI 17.20-25.79) versus atemperature of 38.0-38.5°C. Fever after vaccination (OR 0.29; 95% CI 0.25-0.33) or reported during office hours (OR 0.17; 95% CI 0.15-0.20) were less likely to result in referral to ER or hospital admission. Conclusion:WithinthissampleofUSpediatricians,perceptionoftheseverityoffeverininfants,aswellasthe responsetoinfantfever